Cross-sectional blood vessel area differences in various causes of death in unenhanced forensic post-mortem computed tomography.

Authors

Cynthia Ruedin, Chantal Fridle, Conny Hartmann, Wolf-Dieter Zech

Published in

International journal of legal medicine. Jul 06, 2026. Epub Jul 06, 2026.

Abstract

In forensic autopsies, the terminal circulatory status in the form of acute congestion or findings consistent with severe blood loss can be significant, as it may indicate different causes of death. However, the autopsy-related description of acute congestion or severe blood loss is predominantly subjective. Post-mortem computed tomography (PMCT) offers the possibility of recording metric parameters such as the cross-sectional area of blood vessels, which could be used for the objective description of acute congestion or severe blood loss. The aim of the present study was therefore to record and compare the cross-sectional areas of smaller and larger blood vessels for different causes of death in forensic PMCT.
In n = 500 forensic autopsy cases (n = 250 men and n = 250 women), the cross-sectional area of various blood vessels near the heart (internal jugular veins, subclavian veins, pulmonary trunk, ascending aorta, descending thoracic aorta, superior vena cava, and inferior vena cava) was measured using PMCT. The cross-sectional area measurements were compared for different causes of death (acute cardiac arrest due to underlying myocardial disease, pulmonary embolism, pneumonia, hypothermia, central dysregulation due to head trauma, suffocation, strangulation, drowning, fatal hemorrhage, and intoxication) in each vessel examined.
For all causes of death combined, significant differences (p < 0.05) between men and women were found for each individual vessel. In each vessel examined, the lowest mean cross-sectional area measurements were observed in fatal hemorrhage (HE), and the highest mean cross-sectional area measurements were observed in pulmonary embolism (PE) and acute cardiac arrest (CA) in both sexes. The PE and CA groups, as well the HE groups, differed significantly from all other causes of death in both men and women.
PMCT cross-sectional area measurements of larger and smaller blood vessels near the heart can be used to objectively describe the terminal circulatory status in cases of pronounced acute blood congestion or fatal hemorrhage.

PMID:
42406089
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.

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